DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grewatz, Derek Ethan	DOIID	520134	NAIC NPN	3811519

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/11/2001	12/3/2012
Inactive	Non Resident	Agent	Casualty	1/11/2001	12/3/2012
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	1/11/2001	1/3/2013
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	1/11/2001	1/3/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Western States Insurance Agency, Inc.	578307	Agent - Property	10/9/2003	11/26/2012
Inactive	Western States Insurance Agency, Inc.	578307	Agent - Casualty	10/9/2003	11/26/2012